Analysis of the structure of disability due to cerebrovascular pathology against the background of stenotic processes in brachiocephalic arteries

Authors:

Dudkina Olga Vladimirovna – PhD in Medical sciences (Cand. Med. Sci.), Associate Professor, Associate Professor of the Department of Neurology of the Albrecht Federal Scientific and Educational Centre of Medkal and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: 79217447243@yandex.ru; https://orcid.org/0000-0003-1501-4838.

Ponomarenko Gennadiy Nikolaevich – Corresponding Member of the Russian Academy of Sciences, Honored Scientist of the Russian Federation, Grand PhD in Medical sciences (Dr. Med. Sci.), Professor, Director General of the Albrecht Federal Scientific and Educational Centre of Medkal and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; Head of the Department of Physical and Rehabilitation Medicine of the North-Western State Medical University named after I.I. Mechnikov, 47 Piskarevskiy Avenue, 195067 St. Petersburg, Russian Federation; e-mail: ponomarenko_g@mail.ru; https://orcid.org/0000-0001-7853-4473.

Pomnikov Viktor Grigorievich – Grand PhD in Medical sciences (Dr. Med. Sci.), Professor, Head of the Department of Neurology of the Albrecht Federal Scientific and Educational Centre of Medkal and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: v.pomnikov@yandex.ru; https://orcid.org/0000-0002-4241-0644.

Kritskaya Larisa Anatolyevna – PhD in Medical sciences (Cand. Med. Sci.), Associate Professor, Associate Professor of the Department of Neurology of the Albrecht Federal Scientific and Educational Centre of Medkal and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: kritskaya1957@mail.ru; https://orcid.org/0000-0001-8377-7859.

Annotation:

Introduction. Currently, an increase in cases of cerebrovascular diseases persists in many countries of the world, which is associated with an increase in life expectancy, exposure to information stress and global instability. Cerebrovascular pathology continues to be one of the main causes of death and disability, second only to oncological diseases in these indicators.

Aim. Objectification and analysis of trends in the development of disability in the population with cerebrovascular pathology against the background of stenotic processes in the brachiocephalic arteries based on an assessment of the possibilities of static analysis.

Materials and methods. A static analysis of 5,912 cases of disability in patients with consequences of cerebral circulatory disorders in the period 2015-2023 was carried out in a single automated vertically integrated information and analytical system.

Results. As a result of the work carried out, significant differences were obtained. According to the Mann – Whitney criterion (p=0,001), men become disabled at a younger age (men predominate before the age of 74, and women predominate after the age of 74 in a ratio of 1:1,4). This is consistent with the early development of cardiovascular diseases in men and a longer life expectancy in women. Correlation analysis confirmed a weak but significant relationship between gender and disability group (p=0.01), as well as between gender and the fact of stenosis of the brachiocephalic arteries (p=0.05), indicating a gender unevenness of pathology. Age also correlates with stenosis (p=0.01), increasing the risk of disability with age, but does not affect the severity of disability (there is no linear dependence on age).

Discussion. Stenosis of the brachiocephalic arteries mainly affects the elderly population, which necessitates the development of specialized medical and social care programs taking into account the age characteristics of patients. Analysis of data for the period 2014-2024 revealed statistically significant dynamics: a steady increase in the proportion of patients aged 60-74 years (for example, among men from 35.3 to 56.5 %) and a decrease in the proportion over 74 years (for example, among women from 30.8 to 17.1 %). This indicates a “rejuvenation” of the disabled population associated with improved diagnosis, improved treatment effectiveness, longer life, and changes in environmental/social factors.

Summary. Statistical data indicate a complex and ambiguous dynamics of disability of the population due to cerebrovascular pathology. The main risk group is shifting from the “senile age” category to the “elderly age” category. This may be due to improved diagnosis (earlier detection), increased effectiveness of treatment and prolonging the life of the general population, as well as changes in environmental or social factors. The data obtained indicate the need to develop more effective measures for the prevention, treatment and medical and social support of patients with this pathology.

List of cited literature:

1. Fizicheskaya i reabilitacionnaya medicina : nacion-al’noe rukovodstvo /Pod red. G. N. Ponomarenko [Physical and Rehabilitation Medicine: National Guidelines / Edited by GN Ponomarenko]. Moscow : GEOTAR-Media. 2025. 704 p. (In Russian).

2. Kliniko-ekspertnaya nevrologiya [Clinical and Expert Neurology]. Rukovodstvo dlya vrachej / Pod redaktsiej prof. VG. Pomnikova, Tom 1. [A Guide for Doctors. Volume 1. Edited by Prof. VG Pomnikov, Volume 1]. SPb, «Gippokrat» [St. Petersburg: Hippocrates]. 2023. 400 p. (In Russian).

3. Shoshmin AV, Ponomarenko GN. MKF v reabilitatsii [ICF in rehabilitation]. Izd-e 2-e pererab. i dop [Ed. 2rd revision. and additional]. SPb. FNTsRI im. G.A. Albrekhta [St. Petersburg: FnCRI named after GA Albrecht]. 2020. 232 p. (In Russian).

4. Kovlen DV, Adkhamov BM, Merzlikin AV, Ponomarenko GN. Razrabotka klinicheskikh re-komendatsii po fizicheskoi i reabilitatsionnoi medits-ine: sovremennoe sostoyanie voprosa [Development of clinical recommendations in physical and rehabilitation medicine: current state of the issue]. Sovremennye problemy nauki i obrazovaniya [Modern problems of science and education]. 2017;(4):34. (In Russian).

5. Shoshmin AV, Ponomarenko GN. MKF v reabili-tatsii [ICF in rehabilitation]. 2nd ed., rev. and suppl. St. Petersburg: Bez izdatel’stva; 2020. 232 p. (In Russian).

6. Informatsionnaya spravka «O pokazatelyakh deyatel’nosti i rezul’tatakh raboty Federal’nogo kazen-nogo uchrezhdeniya «GB MSE po g. Sankt-Peterburgu» Mintruda Rossii za 2019 god [Information note “On the performance indicators and results of the Federal State Institution “GB MSE in St. Petersburg” of the Ministry of Labor of the Russian Federation for 2019]. (In Russian).

7. Kulagina EN, Polina NA, Razumovskii AV Sotsial’naya infrastruktura: ehkonomicheskie problemy i pers-pektivy [Social Infrastructure: Economic Problems and Prospects]. Monografiya – N.Novgorod: IzD-vo «Dyatlovy gorY» [Monograph – Nizhny Novgorod: Dyatlovy Gory Publishing House]. 2010. 428 s. (In Russian).

8. Fisun AYa, Shchegolkov AM, Yudin VE, Ponomarenko GN. Meditsinskaya reabilitatsiya v Vooruzhennykh Silakh: istoki, sovremennoe sostoyanie i perspektivy [Medical rehabilitation in the Armed Forces: origins, current state and prospects]. Voenno-medicinskij zhurnal [Military Medical Journal]. 2014;335(8):4-15. (In Russian).